Direct thrombin inhibitors

Card Set Information

Author:
merazar15
ID:
228596
Filename:
Direct thrombin inhibitors
Updated:
2013-07-30 09:51:15
Tags:
Direct thrombin inhibitors
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Description:
pharm-direct thrombin inhibitors
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  1. parental drugs:
    • Hirudin
    • Bivalirudin
    • Desirudin
    • Argatroban
  2. oral drugs:
    • Dabigatran
    • Ximelagatran
  3. MOA:
    • binds to thrombin directly at its active site
    • inhibition of thrombin results in an anticoagulant effect
  4. Indications:
    • Postsurgical VTE prophylaxis
    • Severe heparin-induced thrombocytopenia (HIT)
  5. CI:
    SE:
    • CI: pts at high risk for bleeding
    • SE: bleeding
  6. Dabigatran indication & dose:
    • Prevention of stoke and systemic embolism in patients with A-fib
    • 150mg po BID-  on exam
  7. Argatroban indication & dose:
    • Anticoagulation in patients with A-fib
    • Initial dose: 2 mcg/kg/min IV
    • Maintenance: adjust dose until the steady-state aPTT is 1.5-3 times the initial baseline value
  8. what is the advantage of direct over indirect thrombin inhibitors (LMWHs)?
    they provide more predictable anticoagulation
  9. how do you monitor the anticoagulation of bivalirudin and argatroban?
    aPTT

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